- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,671.50 / $26,874.60 / $38,051.60
| Facility | | $14,671.50 | $26,874.60 | $38,051.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,058.61 / $27,363.71 / $43,004.70
| Facility | | $17,058.61 | $27,363.71 | $43,004.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,253.92 / $24,175.15 / $43,011.43
| Facility | | $15,253.92 | $24,175.15 | $43,011.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $23,125.06 / $50,861.10
| Facility | | $7,117.00 | $23,125.06 | $50,861.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $22,312.32 / $45,197.83
| Facility | | $3,308.00 | $22,312.32 | $45,197.83 |